Document Detail


The effect of lung-protective permissive hypercapnia in intracerebral pressure in patients with subarachnoid haemorrhage and ARDS. A retrospective study.
MedLine Citation:
PMID:  20700747     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: Lung protective ventilation has a beneficial effect in treating patients with acute respiratory distress syndrome (ARDS). An effect of this ventilation modality is hypercapnia, which leads to increased cerebral blood flow. Since increased cerebral blood flow can induce brain oedema the question arises whether lung protective ventilation can be applied in patients with subarachnoid haemorrhage.
METHODS: We retrospectively analysed 12 patients with subarachnoid haemorrhage who were ventilated with lung protective ventilation since they suffered of ARDS. Tidal volume was 5-8 ml/kg body weight, and positive end expiratory pressure was 10-15 cm H₂O. Intracerebral pressure was continuously measured by intracerebral probe.
RESULTS: Despite of hypercapnia (pCO₂ 50-60 mmHg) there was no increase of the intracerebral pressure. Lung protective ventilation could be safely performed in patients with subarachnoid haemorrhage.
CONCLUSION: Patients with higher Hunt and Hess grades of subarachnoid haemorrhage who are predominantly intubated and ventilated and most of them suffer from ARDS can receive lung protective ventilation. In our small patient collective, the occurring hypercapnia did not influence (increase) the intracerebral pressure.
Authors:
Athanasios K Petridis; Alexandros Doukas; Sven Kienke; Homajoun Maslehaty; Mehran Mahvash; Harald Barth; Hubertus Maximilian Mehdorn
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Publication Detail:
Type:  Journal Article     Date:  2010-08-11
Journal Detail:
Title:  Acta neurochirurgica     Volume:  152     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  2143-5     Citation Subset:  IM    
Affiliation:
Neurosurgical Department, University Hospital Schleswig Holstein, Kiel, Germany. opticdisc@aol.com
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Comment In:
Acta Neurochir (Wien). 2010 Dec;152(12):2173-4   [PMID:  20714760 ]

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